Volatile organic compounds in breath can serve as a non-invasive diagnostic biomarker for the detection of advanced adenomas and colorectal cancer

van Keulen, K. E., Jansen, M. E., Schrauwen, R. W. M., Kolkman, J. J. & Siersema, P. D., Feb-2020, In : Alimentary Pharmacology & Therapeutics. 51, 3, p. 334-346 13 p.

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Background Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world. Aim To evaluate if exhaled volatile organic compounds (VOCs) can serve as a non-invasive biomarker for the detection of CRC and precursor lesions using an electronic nose. Methods In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two-thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final-disease models to further improve the discriminatory power of the algorithms. Results Five hundred and eleven breath samples were collected. Sixty-four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non-advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively. Conclusions This study suggests that exhaled VOCs could potentially serve as a non-invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre-)malignant colorectal lesions. ( Identifier NCT03488537)

Original languageEnglish
Pages (from-to)334-346
Number of pages13
JournalAlimentary Pharmacology & Therapeutics
Issue number3
Publication statusPublished - Feb-2020



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